United States District Court, D. Massachusetts
LLOYD F. AUDETTE, Plaintiff,
ADRIANA CARRILLO, M.D.; CHARLES DICECCA, M.D.; MASSACHUSETTS PARTNERSHIP FOR CORRECTIONAL HEALTHCARE, LLC; MARIE ANGELES, M.D.; SUPERINTENDENT KELLY RYAN, Defendants.
MEMORANDUM AND ORDER
ALLISON D. BURROUGHS U.S. DISTRICT JUDGE.
case concerns the quality of the medical care that Plaintiff
Lloyd Audette received while incarcerated at the
Massachusetts correctional institutions in West Concord and
Shirley (“MCI Concord” and “MCI Shirley,
” respectively). Plaintiff claims that Defendants were
deliberately indifferent to his serious medical needs, that
when he complained of mistreatment, medical treatment was
withheld, and that the care he eventually received was
negligently provided. Before the Court are two motions for
summary judgment-one filed by Defendant Adriana Carrillo,
M.D., [ECF No. 167], and the other filed by Defendant Maria
Angeles, M.D., [ECF No. 173]. For the reasons explained
below, Dr. Angeles's motion is GRANTED, and Dr.
Carrillo's motion is GRANTED in part and
DENIED in part.
First Amended Complaint [ECF No. 16] asserted claims against
eleven defendants, including (1) claims under 42 U.S.C.
§ 1983 for violation of rights guaranteed by the First,
Eighth, and Fourteenth Amendments to the United States
Constitution, and conspiracy to violate those rights through
deliberate indifference as against Dr. Carrillo, Dr. Angeles,
and others (Count I) and retaliation as against all
Defendants (Count II), (2) violations of the Massachusetts
Declaration of Rights and civil conspiracy as against Dr.
Carrillo, Dr. Angeles, and others (Count III), (3) negligence
as against Dr. Angeles and UMass Correctional Health (Count
IV); and (4) negligence as against Dr. Carrillo and others
(Count V), and (5) negligent infliction of emotional distress
as against Dr. Carrillo and others (Count VI).
Carrillo and Dr. DiCecca answered the Complaint [ECF Nos. 24,
37], while the remaining Defendants, including Dr. Angeles,
moved to dismiss. [ECF Nos. 42, 55, 57, 62]. Two defendants
had all claims against them dismissed by the Court [ECF No.
72],  and five additional defendants were
dismissed by stipulation.
Court dismissed Plaintiff's negligence and conspiracy
claims against Dr. Angeles, but denied her motion to dismiss
the non-conspiracy portions of Counts I, II, and III, leaving
the claims for violations of federal and state constitutional
rights pending against Dr. Angeles. [ECF No. 72 at 16].
Counts I, II, III, V, and VI-violations of constitutional
rights, negligence, and negligent infliction of emotional
distress-remain pending against both Dr. Carrillo and Dr.
DiCecca. Dr. DiCecca has not filed a motion for summary
required by the applicable legal standard on a motion for
summary judgment, the following factual summary draws all
reasonable inferences in favor of Plaintiff as the
being convicted of armed robbery in October 2009, Plaintiff
began a period of incarceration at MCI facilities that lasted
until May 2017. [ECF No. 181 ¶ 22]. Plaintiff contends
that when he arrived at MCI Shirley in 2009, Dr. Angeles, who
supervised Plaintiff's medical care there, told him
“you will not receive any medical treatment because you
like to file grievances.” [ECF No. 184 ¶¶ 3,
6]. Plaintiff suffered from a degenerative joint disease and
had received oxycodone for pain management during a prior
period of incarceration, but Dr. Angeles discontinued that
prescription. [ECF No. 184 ¶¶ 9-10]. Dr. Angeles
provided Plaintiff with limited treatment in 2010 and 2011
but neglected to provide pain medication stronger than
over-the-counter, nonsteroidal anti-inflammatory agents and
refused to see Plaintiff for several weeks in September 2010.
[ECF No. 181 ¶¶ 5, 7; ECF No. 183-2 at 47:3-10]. In
October 2011, a nurse practitioner at MCI Shirley recommended
that Plaintiff receive a total left knee replacement [ECF No.
181 ¶ 8].
Department of Correction contracts third parties to provide
health services to inmates, and Lemuel Shattuck Hospital
(“Shattuck”) is the primary referral hospital for
patients in need of off-site surgeries. [ECF No. 179-6 at
137-138]. Shattuck in turn contracts with medical groups to
meet its need for physicians. Pursuant to such a contractual
arrangement, Dr. Carrillo as an employee of Orthopedic
Trauma, P.C., provided care to Plaintiff, as well as to
members of the general public, at Shattuck. [ECF No. 180
March 29, 2012, Plaintiff saw Dr. Carrillo for the first time
for a consultation. After X-rays revealed osteoarthritis in
Plaintiff's left knee, Dr. Carrillo explained that a knee
replacement would be the next step. [ECF No. 180 ¶¶
8, 9]. She further explained to Plaintiff that the waiting
period for the surgery would be six months to a year and gave
Plaintiff a cortisone injection in his left knee in the
meantime. [ECF No. 180 ¶ 10]. Shattuck planned to
schedule Plaintiff's knee replacement as soon as it was
approved by the Department of Correction. [ECF No. 180 ¶
Shirley, the committee responsible for reviewing inmates'
medical treatment options denied Plaintiff's request for
a knee replacement ostensibly because Dr. Angeles failed to
properly fill out the required paperwork. [ECF No. 181 ¶
9]. Plaintiff learned that his request had been denied in the
summer of 2012 due to the incomplete paperwork. He spoke with
state officials who had the paperwork resubmitted and his
knee replacement was then approved. [ECF No. 184 ¶¶
August 14, 2012 Shattuck scheduled Plaintiff for a total knee
replacement. [ECF No. 184 ¶ 26]. He was admitted for the
procedure on December 18, 2012, and Dr. DiCecca performed the
knee replacement on December 19, 2012, with assistance from
Dr. Carrillo, whose role was limited to holding a retractor.
[ECF No. 180 ¶¶ 12-16]. During the procedure, a
branch of Plaintiff's popliteal vein was cut. [ECF No.
180 ¶ 17]. Dr. DiCecca and Dr. Carrillo consulted with a
general surgeon at Shattuck, who did not find evidence of
acute bleeding or an interruption to the venous or arterial
system but recommended that Plaintiff be placed on either
Coumadin or subcutaneous Heparin following the procedure.
[ECF No. 180 ¶¶ 18-20]. Checks of Plaintiff's
International Normalized Ratio (“INR”) levels
were ordered for the seven days following his knee
replacement to ensure that the correct dose of Coumadin was
being administered. [ECF No. 180 ¶ 21]. In violation of
both Shattuck policy and the standard of care,
Plaintiff's INR levels were not checked during the first
four days following his surgery and Coumadin was administered
in incorrect doses. [ECF No. 180 ¶¶ 22-23]. As a
result, Plaintiff had internal bleeding which resulted in a
hematoma in Plaintiff's left leg and pain that left him
unable to sleep. [ECF No. 180 ¶¶ 19, 24, No. 181
¶ 15]. Plaintiff remained hospitalized until January 8,
2013, when he was transferred back to an MCI facility. [ECF
No. 180 ¶ 25].
point after the December 18 surgery, Plaintiff developed
laxity of his left knee, which necessitated revision surgery.
[ECF No. 180 ¶ 28]. Dr. DiCecca performed the revision
surgery on March 12, 2013 without assistance from Dr.
Carrillo. [ECF No. 180 ¶¶ 29, 30]. Despite the
revision surgery, Plaintiff continued to experience joint
pain and instability in his left knee.
Dr. Carrillo again on April 11, 2013, [ECF No. 179-4 ¶
42], and claims that during that visit Dr. Carrillo told him,
“You're not getting a third surgery, your knee can
just stay the way it is.” [ECF No. 181 ¶ 19]. At
some point, Plaintiff threated Dr. Carrillo with a
lawsuit. [ECF No. 180 ¶¶ 31-32]. Dr.
Carrillo's professional opinion was that Plaintiff was
“never going to be happy with whatever we did, ”
but she nevertheless referred him to Dr. DiCecca, who met
with Plaintiff on May 22, 2013 and advised him to “live
with the situation as it is.” [ECF No. 179-4
¶¶ 42-43, No. 179-5 at 119:16-19].
next consulted with a nurse practitioner at MCI Concord, who
noted on July 17, 2013 that his “knee [was] still very
unstable with severe laxity and crepitus.” [ECF No.
179-3 at 97-105]. On November 7, 2013 and January 22, 2014,
Plaintiff met again with Dr. DiCecca, who noted that it was
not entirely clear what was causing his continued pain but
told him not to pursue additional treatment. [ECF No. 179-4
12, 2015, Plaintiff was again examined by staff at Shattuck
who told him that he needed an additional knee surgery but
that that would require approval from Dr. Carrillo. This
surgery was never arranged. [ECF No. 181 ¶ 21].
Plaintiff claims that the Shattuck staff met with Dr.
Carrillo after he left and then reversed their view that he
needed an additional surgery. [ECF No. 181 ¶ 21]. In
response, Plaintiff filed a formal grievance and a lawsuit.
[ECF No. 179-2 at 2].
15, 2017 just days after his eventual release from custody,
Plaintiff was treated at Tufts Medical Center, where the
doctors determined that his left knee replacement had
“failed.” [ECF No. 179-4 ¶ 49]. On June 1,
2017, Plaintiff was scheduled for total hip and knee
replacement surgeries, which were justified based on
“severe pain associated with [the] activities of daily
living.” [ECF No. 179-4 ¶ 49].
judgment is appropriate “if the movant shows that there
is no genuine dispute as to any material fact and the movant
is entitled to judgment as a matter of law.”
Fed.R.Civ.P. 56(a). The Court must consider the facts of
record and draw “all reasonable inferences therefrom in
the light most favorable to the nonmoving party.”
Borges ex rel. S.M.B.W. v. Serrano-Isern, 605 F.3d
1, 4 (1st Cir. 2010) (citing Houlton Citizens' Coal.
v. Town of Houlton, 175 F.3d 178, 183-84 (1st
Cir.1999)). The Court will not, however, “draw
unreasonable inferences or credit bald assertions, empty
conclusions, rank conjecture, or vitriolic invective.”
Pina v. Children's Place, 740 F.3d 785, 795 (1st
Cir. 2014) (citation omitted). “An issue is
‘genuine' if the evidence of record permits a
rational factfinder to resolve it in favor of either party,
” and a “fact is ‘material' if its
existence or nonexistence has the potential to change the
outcome of the suit.” Borges, 605 F.3d at 4-5.
The substantive law determines which facts are material.